FLUID AND ELECTROLYTES
FAILURE
INTRODUCTION: THE KIDNEYS
[Adrenal Gland on the upper part of the
kidney]
 Composed of 1.3 million nephrons
each
 Weights 15 grams
 Bean-shaped
 Retroperitoneal location (back of the
peritoneal)
RENAL PHYSIOLOGY
 Excretion of metabolic waste
products (urine)
 125 ml/min (124ml/min reabsorbed;
1ml urine)
 Normal excretion of 8-10mg/day of
albumin (protein)
 
FLUID CONTENT OF THE BODY
 Approx. 58-60%
60% water, 40% tissue and all
 TIE 642-5151
 
TIE 64-5151
 Total body water: 60% (out of
100%)
o Intracellular Fluid: 40%
o Extracellular Fluid: 20%
Plasma: 5%
Interstitial fluid: 15%
Transcellular fluid: <1%
fluids that lubricate
 
Synovial Fluid: fluids bet joints (joints
aspiration)
 
THE AGING KIDNEYS
 Progressive atrophy of nephrons
and decrease in function
(bumabagsak si glomerular flirtation
rate)
 30 yrs old: decline of 1ml/min of
GMR per year (in hx kidney)
 In diseased kidney, decline is more
rapid by 500% (5x faster)
Hypertension: 5ml/yr
DM: 5ml/yr
RIFLE CRITERIA FOR RENAL
e.g
Weight x .5ml/kg/h x 6hours
40kg x .5ml= 20ml/h x 6 hours =
120 ml
 
ESRD: end stage renal disease: no urine
output "anuria"
 
COMMON DISEASES OF THE
KIDNEYS
1. DIABETE MELLITUS
 Diabetic nephropathy
 Blood vessels sa kidney
naay problem naga
constrict dli na maka flow
ug tarung
2. HYPERTENSION
 Hypertensive kidney disease
 Intimal deposition (tunica
intema): naay deposit ng
taba (atheroma:
deposition of fat),
sumisikip bc of
fat>narrow> tunica intem
mukapal>rteriosclerosis
(hardening of
bloodvessels)
Arterio: hardening
Athero: madaming taba
1. OBSRTUCTIVE NEPHROPATHY
 Acute tubular obstruction
secondary to deposition
(calcium)
Stag-horn calculi: kidney stone
(made of calcium)
 Post-ileal resection, small
bowel surgery (hypovolemia,
shorter transit time)
 (large intestine left: low ang Renal sinus: contain upper dilated end of
water absorption) Right kidney: T12- L3; lower
  Left kidney: T11- L2 (slightly more
1. URATE NEPHROPATHY (GOUT) superior); higher
 Uric acid dugay na sa blood:  
hyperuricemia (uric acid> LEFT KIDNEY: USE FOR
urate crystals which damages TRANSPLANT; AORTA (ABDOMINAL
the kidney tissue). AORTA) NAA SA LEFT; RENAL VEIN
2. SLE TAAS
 Kidney destroyed bc 90% of  
glomeruli are sclerotic and w GENITOURINARY ANOMALIES:
microthromboses (malilit na 1. SUPERNUMERARY RENAL
clot) ARTERIES: renal arteries dapat 1
3. CHRONIC lg
GLOMERULONEPHRITIS (hubag 2. DOUBLE RENAL PELVIS: isa lg
kidney) dapat
 Infection can lead to death 3. HORSESHOE KIDNEY:
 Urine flow impeded (blocked) connected both kidney
by tubular obstruction 4. MEGALOURETER: not
secondary to interstitial contracted: dilated of water
inflammation and fibrosis. (urine): no contraction so no
peristalsis>prone to urinary stasis:
ga blackflow ang ihi
GENITOURINARY SYSTEM 5. POSTCAVAL URETER: ureter
ABNORMALITIES nasabit/umikot
KIDNEY: reddish brown, behind the
peritoneum
 Lie superiorly in the posterior
abdominal wall on either side of the
vertebral column
 Protected by the costal margin
 
Covered by:
o Fibrous capsule (surrounds
the kidney)
o Perirenal fat (covers the
fibrous capsule)
o Renal fascia (covers perirenal
fat and the suprarenal glands)
o Pararenal fat (external to renal
fascia; forms part of the
peritoneal fat)
 
Dark brown outer cortex
Light brown inner medulla
12 renal pyramids
Apex aka renal papillae
Bet. renal pyramids are renal
columns